Provider Demographics
NPI:1609452390
Name:VALDEZ, NATALIE (DDS)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2188 N BUCKINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-1460
Mailing Address - Country:US
Mailing Address - Phone:909-921-3472
Mailing Address - Fax:
Practice Address - Street 1:12420 DAY ST STE B4
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-7536
Practice Address - Country:US
Practice Address - Phone:951-656-6538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1059671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice